Re: Religion Thread: That's Me In the Corner...
I have actually, at times, found it very difficult to determine capacity in patients during urgent, on the spot, evaluations when they make grandiose religious based claims. If I know a patient well, it really is not that hard. But on a night shift, when you are covering 100 patients that you have 2-3 lines on, you have not seen during the daylight, and you get called to a "Code Violet" and find several hospital cops securing an extremely upset patient who wants to leave the hospital because God told them there was important work to do that night...it is not as easy.
For instance, if I were hospitalized for severe pneumonia and at 2 AM, decide I want to leave, one could hand me my AMA paperwork and send me on my way if they deem I have capacity. Now if I were saying about how God will protect me, pneumonia is the devil's work and all I need is prayer, a physician who knows me should deem me non-decisional based on my prior actions/beliefs. However, swap me out with a patient who is very religious, says things like that when not acutely ill...do they have capacity?
**** ....just realized that was off topic. Anyway...I have had a patient be disappointed that we fixed their seizures because they associated them with gods voice. Our confidence was not based on a "belief," we saw the seizures...we saw them associated on video and EEG...the areas of increased activity correlated with current understanding of neuroanatomy...and we saw them (both EEG activity and the voice) resolve with proper anti-epileptics. Nothing mysterious...just our wonderful brain misbehaving in a consistent, repeatable, and mappable manner.
Originally posted by Kepler
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For instance, if I were hospitalized for severe pneumonia and at 2 AM, decide I want to leave, one could hand me my AMA paperwork and send me on my way if they deem I have capacity. Now if I were saying about how God will protect me, pneumonia is the devil's work and all I need is prayer, a physician who knows me should deem me non-decisional based on my prior actions/beliefs. However, swap me out with a patient who is very religious, says things like that when not acutely ill...do they have capacity?
**** ....just realized that was off topic. Anyway...I have had a patient be disappointed that we fixed their seizures because they associated them with gods voice. Our confidence was not based on a "belief," we saw the seizures...we saw them associated on video and EEG...the areas of increased activity correlated with current understanding of neuroanatomy...and we saw them (both EEG activity and the voice) resolve with proper anti-epileptics. Nothing mysterious...just our wonderful brain misbehaving in a consistent, repeatable, and mappable manner.
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